medjournalМедицинский журналMedical Journal1818-426XБелорусский государственный медицинский университет10.51922/1818-426X.2026.3.105medjournal-456Research ArticleОРИГИНАЛЬНЫЕ НАУЧНЫЕ ПУБЛИКАЦИИORIGINAL SCIENTIFIC PUBLICATIONSДинамика показателей общего анализа крови и С-реактивного белка у пациентов с ХОБЛ и различной выраженностью обструктивных изменений в легкихDYNAMICS OF COMPLETE BLOOD TEST AND C-REACTIVE PROTEIN VALUES IN PATIENTS WITH COPD AND VARIOUS SEVERITIES OF OBSTRUCTIVE CHANGES IN THE LUNGТагановичА. Д.TaganovichA. D.

Минск

Minsk

КовганкоН. Н.KovgankoN. N.

Минск

Minsk

НикитинаИ. А.NikitinaI. A.

Минск

Minsk

РябцеваТ. В.RyabtsevaT. V.

Минск

Minsk

ДавидовскаяЕ. И.DavidovskayaE. I.

Минск

Minsk

БогушЛ. С.BogushL. S.

Минск

Minsk

БудникО. А.BudnikO. A.

Минск

Minsk

УО Белорусский государственный медицинский университетБеларусьBelarusian State Medical UniversityBelarusГУ «Республиканский научно-практический центр пульмонологии и фтизиатрии»БеларусьRepublican Scientific and Practical Center of Pulmonology and PhthisiologyBelarus20262407202603105111Copyright © Таганович А.Д., Ковганко Н.Н., Никитина И.А., Рябцева Т.В., Давидовская Е.И., Богуш Л.С., Будник О.А., 20262026Таганович А.Д., Ковганко Н.Н., Никитина И.А., Рябцева Т.В., Давидовская Е.И., Богуш Л.С., Будник О.А.Taganovich A.D., Kovganko N.N., Nikitina I.A., Ryabtseva T.V., Davidovskaya E.I., Bogush L.S., Budnik O.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medjournal.ejournal.by/jour/article/view/456

Работа посвящена определению динамики показателей общего анализа крови (ОАК) и С-реактивного белка (СРБ) у пациентов с ХОБЛ и различной выраженностью обструктивных изменений в легких в период обострения заболевания, в процессе его лечения и в отдаленный период после обострения.

Обследованы 61 пациент с диагнозом ХОБЛ и 27 человек без признаков патологии. Пациенты обследовались до начала стационарного лечения, а также спустя 14 и 90 суток. В образцах венозной крови определяли концентрацию клеток, СОЭ, в сыворотке крови – уровень СРБ. Результаты анализировали непараметрическими методами описательной статистики.

Независимо от степени развития обструктивных изменений в легких, в крови пациентов с ХОБЛ до начала лечения имелись признаки системного воспаления. Это выражалось в увеличении уровня лейкоцитов, концентрации и относительного количества нейтрофилов, при выраженной обструкции – лимфоцитов и моноцитов, СОЭ и СРБ по сравнению с контрольными значениями. Через 14 суток, вопреки ожидаемому снижению на фоне проводимой терапии, происходил дальнейший рост или сохранение высокого уровня этих показателей. Через 90 суток уровень лейкоцитов, нейтрофилов, моноцитов и СРБ значимо снизился по сравнению с пиком через 14 суток, приближаясь к исходным значениям (до начала лечения), но все еще превышал норму.

Наблюдавшиеся изменения являются характерным признаком хронического, плохо контролируемого системного воспаления, которое является ключевым фактором, определяющим прогрессирование заболевания и риск неблагоприятных исходов.

This study aims to determine the dynamics of complete blood count (CBC) and C-reactive protein (CRP) levels in patients with COPD varying degrees of obstructive pulmonary changes during an exacerbation, treatment, and in stable period.

61 patients with COPD and 27 individuals without signs of pathology were examined. Patients were examined before the start of inpatient treatment and after 14 and 90 days. Cell count and ESR were determined in venous blood samples, and CRP levels were measured in serum. The results were analyzed using nonparametric descriptive statistics.

Regardless of the severity of obstructive pulmonary changes, signs of systemic inflammation were present in the blood of patients with COPD before treatment. This was manifested by an increase in leukocyte count, the concentration and relative number of neutrophils, and, in cases of severe obstruction, an increase in lymphocytes and monocytes, ESR, and CRP compared to control values. After 14 days, contrary to the expected decrease during therapy, these indicators continued to increase or remained high. After 90 days, levels of leukocytes, neutrophils, monocytes, and CRP had significantly decreased compared to the peak after 14 days, approaching baseline values (before treatment), but still exceeded normal.

These observed changes are characteristic of chronic, poorly controlled systemic inflammation, which is a key factor determining disease progression and the risk of adverse outcomes.

анализ кровиС-реактивный белокХОБЛblood testC-reactive proteinCOPDReferencesЛицкевич, Л. В. Коморбидные нарушения сердечнососудистой системы и качество жизни пациентов с хронической обструктивной болезнью легких в Республике Беларусь / Л. В. Лицкевич // Журнал кардиореспираторных исследований. – 2022. – Т. 3, № 1. – С. 47–51. – doi: 10.5281/zenodo.6401166.Litskevich, L. V. Komorbidnyye narusheniya serdechno-sosudistoy sistemy i kachestvo zhizni patsiyentov s khronicheskoy obstruktivnoy bolezn'yu legkikh v Respublike Belarus' [Comorbid disorders of the cardiovascular system and quality of life of patients with chronic obstructive pulmonary disease in the Republic of Belarus] / L. V. Litskevich // Zhurnal kardiorespiratornykh issledovaniy. – 2022. – Vol. 3, № 1, – P. 47–51. – doi: 10.5281/ zenodo.6401166 [in Russian].Patel, N. An update on COPD prevention, diagnosis and management: The 2024 GOLD Report / N. Patel // Nurse Practitioner. – 2024. – Vol. 49, № 6. – P. 29–36. – doi: 10.1097/01.NPR.0000000000000180.Patel, N. An update on COPD prevention, diagnosis and management: The 2024 GOLD Report / N. Patel // Nurse Practitioner. – 2024. – Vol. 49, № 6. – P. 29–36. – doi: 10.1097/01.NPR.0000000000000180.Agarwal, A. K. Chronic Obstructive Pulmonary Disease / A. K. Agarwal, A. Raja, B. D. Brown // In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.Agarwal, A. K. Chronic Obstructive Pulmonary Disease / A. K. Agarwal, A. Raja, B. D. Brown // In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2025.Markers of exacerbation severity in chronic obstructive pulmonary disease / L. G. Franciosi, C. P. Page, B. R. Celli [et al.] // Respirtory Research. – 2006. – Vol. 7, № 1. – P. 74–83. – doi: 10.1186/1465-9921-7-74.Markers of exacerbation severity in chronic obstructive pulmonary disease / L. G. Franciosi, C. P. Page, B. R. Celli [et al.] // Respirtory Research. – 2006. – Vol. 7, № 1. – P. 74–83. – doi: 10.1186/1465-9921-7-74.Blood fibrinogen as a biomarker of chronic obstructive pulmonary disease / A. Duvoix, J. Dickens, I. Haq [et al.] // Thorax. – 2013. – Vol. 68, № 7. – P. 670–676. – doi: 10.1136/thoraxjnl-2012–201871Blood fibrinogen as a biomarker of chronic obstructive pulmonary disease / A. Duvoix, J. Dickens, I. Haq [et al.] // Thorax. – 2013. – Vol. 68, № 7. – P. 670–676. – doi: 10.1136/thoraxjnl-2012–201871Moving towards a Treatable Traits model of care for the management of obstructive airways diseases / A. Agusti, N. Barnes, A. A. Cruz [et al.] // Respiratory Medicine. – 2021. – Vol. 187. – Р. 106572. – c doi: 10.1016/j.rmed.2021.106572.Moving towards a Treatable Traits model of care for the management of obstructive airways diseases / A. Agusti, N. Barnes, A. A. Cruz [et al.] // Respiratory Medicine. – 2021. – Vol. 187. – Р. 106572. – c doi: 10.1016/j.rmed.2021.106572.Emami Ardestani, M. Evaluation of the relationship of neutrophil-to lymphocyte ratio and platelet-to-lymphocyte ratio with in-hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease / M. Emami Ardestani, N. Alavi-Naeini // Clinical Respiratory Journal. – 2021. – Vol. 15, № 4. – P. 382–388. – doi: 10.1111/crj.13312.Emami Ardestani, M. Evaluation of the relationship of neutrophil-to lymphocyte ratio and platelet-to-lymphocyte ratio with in-hospital mortality in patients with acute exacerbation of chronic obstructive pulmonary disease / M. Emami Ardestani, N. Alavi-Naeini // Clinical Respiratory Journal. – 2021. – Vol. 15, № 4. – P. 382–388. – doi: 10.1111/crj.13312.Blood neutrophil counts are associated with exacerbation frequency and mortality in COPD / M. Lonergan, A. J. Dicker, M. L. Crichton [et al.] // Respiratory Research. – 2020. – Vol. 21, № 1. – P. 1–10. – doi: 10.1186/s12931-020-01436-7.Blood neutrophil counts are associated with exacerbation frequency and mortality in COPD / M. Lonergan, A. J. Dicker, M. L. Crichton [et al.] // Respiratory Research. – 2020. – Vol. 21, № 1. – P. 1–10. – doi: 10.1186/s12931-020-01436-7.The mechanistic role of neutrophil lymphocyte ratio perturbations in the leading non communicable lifestyle diseases / M. Biswas, R. Suvarna, S. V. Krishnan [et al.] // F1000 Research. – 2022. – Vol. 11. – P. 960. – doi: 10.12688/f1000research.123245.1.The mechanistic role of neutrophil lymphocyte ratio perturbations in the leading non communicable lifestyle diseases / M. Biswas, R. Suvarna, S. V. Krishnan [et al.] // F1000 Research. – 2022. – Vol. 11. – P. 960. – doi: 10.12688/f1000research.123245.1.Low-Blood Lymphocyte Number and Lymphocyte Decline as Key Factors in COPD Outcomes: A Longitudinal Cohort Study / U. Semenzato, D. Biondini, E. Bazzan [et al.] / Respiration. – 2021. – Vol. 100, № 7. – P. 618–630. – doi: 10.1159/000515180.Low-Blood Lymphocyte Number and Lymphocyte Decline as Key Factors in COPD Outcomes: A Longitudinal Cohort Study / U. Semenzato, D. Biondini, E. Bazzan [et al.] / Respiration. – 2021. – Vol. 100, № 7. – P. 618–630. – doi: 10.1159/000515180.Thrombocytosis is associated with increased short and long term mortality after exacerbation of chronic obstructive pulmonary disease: a role for antiplatelet therapy? / M. T. Harrison, P. Short, P. A. Williamson [et al.] // Thorax. – 2014. – Vol. 69, № 7. – P. 609–615. – doi: 10.1136/thoraxjnl-2013-203996.Thrombocytosis is associated with increased short and long term mortality after exacerbation of chronic obstructive pulmonary disease: a role for antiplatelet therapy? / M. T. Harrison, P. Short, P. A. Williamson [et al.] // Thorax. – 2014. – Vol. 69, № 7. – P. 609–615. – doi: 10.1136/thoraxjnl-2013-203996.Creactive protein as a biomarker of response to inhaled corticosteroids among patients with COPD / O. Oshagbemi, F. Franssen, E. Wouters [et al.] // Pulmonary Pharmacology and Therapeutics. – 2020. – Vol. 60. – P. 101870. – doi: 10.1016/j.pupt.2019.101870.8.Creactive protein as a biomarker of response to inhaled corticosteroids among patients with COPD / O. Oshagbemi, F. Franssen, E. Wouters [et al.] // Pulmonary Pharmacology and Therapeutics. – 2020. – Vol. 60. – P. 101870. – doi: 10.1016/j.pupt.2019.101870.8.Ahmed, B. Relationship between CRP levels and the severity of COPD acute exacerbations among group D COPD patients / B. Ahmed // European Respiratory Journal. – 2020. – Vol. 56, Suppl. 64. – P. 2443. – doi: 10.1183/13993003.congress2020.2443.Ahmed, B. Relationship between CRP levels and the severity of COPD acute exacerbations among group D COPD patients / B. Ahmed // European Respiratory Journal. – 2020. – Vol. 56, Suppl. 64. – P. 2443. – doi: 10.1183/13993003.congress2020.2443.Banerjee, S. Elevated C-reactive protein and mortality risk among COPD patients / S. Banerjee, J. Khubchandani, C. Onukogu // Egyptian Journal of Bronchology. – 2024. – Vol. 18. – Р. 38. – doi: 10.1186/s43168-024-00291-0.Banerjee, S. Elevated C-reactive protein and mortality risk among COPD patients / S. Banerjee, J. Khubchandani, C. Onukogu // Egyptian Journal of Bronchology. – 2024. – Vol. 18. – Р. 38. – doi: 10.1186/s43168-024-00291-0.Stability of blood eosinophils in acute exacerbation of chronic obstructive pulmonary disease and its relationship to clinical outcomes: a prospective cohort study / Y. Cui, W. Zhang, Y. Ma [et al.] // Respiratory Research. – 2021. – Vol. 22, № 1. – Р. 301. – doi: 10.1186/s12931-021-01888-5.Stability of blood eosinophils in acute exacerbation of chronic obstructive pulmonary disease and its relationship to clinical outcomes: a prospective cohort study / Y. Cui, W. Zhang, Y. Ma [et al.] // Respiratory Research. – 2021. – Vol. 22, № 1. – Р. 301. – doi: 10.1186/s12931-021-01888-5.Neutrophil-to-lymphocyte ratio, blood eosinophils and COPD exacerbations: a cohort study /j. Ellingsen, C. Janson, K. Bröms [et al.] // ERJ Open Research. – 2021. – Vol. 7, № 4. – P. 00471–2021. – doi: 10.1183/23120541.00471-2021.Neutrophil-to-lymphocyte ratio, blood eosinophils and COPD exacerbations: a cohort study /j. Ellingsen, C. Janson, K. Bröms [et al.] // ERJ Open Research. – 2021. – Vol. 7, № 4. – P. 00471–2021. – doi: 10.1183/23120541.00471-2021.Blood eosinophil counts, exacerbations, and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomised controlled trials / S. Pascoe, N. Locantore, M. T. Dransfield [et al.] // Lancet Respiratory Medicine. – 2015. – Vol. 3, № 6. – P. 435–442. – doi: 10.1016/S2213-2600(15)00106-X.Blood eosinophil counts, exacerbations, and response to the addition of inhaled fluticasone furoate to vilanterol in patients with chronic obstructive pulmonary disease: a secondary analysis of data from two parallel randomised controlled trials / S. Pascoe, N. Locantore, M. T. Dransfield [et al.] // Lancet Respiratory Medicine. – 2015. – Vol. 3, № 6. – P. 435–442. – doi: 10.1016/S2213-2600(15)00106-X.Sullivan, E. Elevation in white blood cell count after corticosteroid use in noninfected hospitalized patients / E. Sullivan, R. Schulte, M. B. Rothberg //journal of Hospital Medicine. – 2025. – Vol. 20, № 8. – P. 824–828. – doi: 10.1002/jhm.70008.Sullivan, E. Elevation in white blood cell count after corticosteroid use in noninfected hospitalized patients / E. Sullivan, R. Schulte, M. B. Rothberg //journal of Hospital Medicine. – 2025. – Vol. 20, № 8. – P. 824–828. – doi: 10.1002/jhm.70008.The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation / A. Frenkel, E. Kachko, V. Novack //journal of Clinical Medicine. – 2019. – Vol. 8, № 10. – P. 1697. – doi: 10.3390/jcm8101697.The Association of Glucocorticosteroid Treatment with WBC Count in Patients with COPD Exacerbation / A. Frenkel, E. Kachko, V. Novack //journal of Clinical Medicine. – 2019. – Vol. 8, № 10. – P. 1697. – doi: 10.3390/jcm8101697.Blood neutrophil counts are associated with exacerbation frequency and mortality in COPD / M. Lonergan, A. J. Dicker, M. L. Crichton // Respiratory Research. – 2020. – Vol. 21, № 1. – P. 166. – doi: 10.1186/s12931-020-01436-7.Blood neutrophil counts are associated with exacerbation frequency and mortality in COPD / M. Lonergan, A. J. Dicker, M. L. Crichton // Respiratory Research. – 2020. – Vol. 21, № 1. – P. 166. – doi: 10.1186/s12931-020-01436-7.Eosinophilic inflammation in COPD: from an inflammatory marker to a treatable trait / B. David, M. Bafadhel, L. Koenderman [et al.] // Thorax. – 2021. – Vol. 76, № 2. – P. 188–195. – doi: 10.1136/thoraxjnl-2020-215167.Eosinophilic inflammation in COPD: from an inflammatory marker to a treatable trait / B. David, M. Bafadhel, L. Koenderman [et al.] // Thorax. – 2021. – Vol. 76, № 2. – P. 188–195. – doi: 10.1136/thoraxjnl-2020-215167.Blood eosinophil counts in COPD patients compared to controls / U. Kolsum, T. Southworth, N. Jackson [et al.] // European Respiratory Journal. – 2019. –Vol. 54, № 4. – P. 1900633. – doi:10.1183/13993003.00633-2019.Blood eosinophil counts in COPD patients compared to controls / U. Kolsum, T. Southworth, N. Jackson [et al.] // European Respiratory Journal. – 2019. –Vol. 54, № 4. – P. 1900633. – doi:10.1183/13993003.00633-2019.Анаев, Э. Х. Эозинофильная хроническая обструктивная болезнь легких / Э. Х. Анаев // Терапевтический архив. – 2023. – Т. 95, № 8. – С. 696–700. – doi: 10.26442/00403660.2023.08.202316.Anayev, E. Kh. Eozinofil'naya khronicheskaya obstruktivnaya bolezn' legkikh [Eosinophilic chronic obstructive pulmonary disease] / E. Kh. Anayev// Terapevticheskiy arkhiv. – 2023. – Vol. 95, № 8. – P. 696–700. – doi: 10.26442/00403660.2023.08.202316 [in Russian].Moving towards a Treatable Traits model of care for the management of obstructive airways diseases / A. Agusti, N. Barnes, A. A. Cruz [et al.] // Respiratory Medicine. – 2021. – Vol. 187. – Р. 106572. – doi: 10.1016/j.rmed.2021.106572.Moving towards a Treatable Traits model of care for the management of obstructive airways diseases / A. Agusti, N. Barnes, A. A. Cruz [et al.] // Respiratory Medicine. – 2021. – Vol. 187. – Р. 106572. – doi: 10.1016/j.rmed.2021.106572.Barnes, P. J. Cellular and molecular mechanisms of asthma and COPD / P. J. Barnes // Clinical Science (London). – 2017. – Vol. 131, № 13. – P. 1541–1558. – doi: 10.1042/CS20160487.Barnes, P. J. Cellular and molecular mechanisms of asthma and COPD / P. J. Barnes // Clinical Science (London). – 2017. – Vol. 131, № 13. – P. 1541–1558. – doi: 10.1042/CS20160487.

The authors declare that there are no conflicts of interest present.